The invention relates to novel compounds which are inhibitors of serine proteases such as tissue factor (TF)/factor VIIa, factor Xa, thrombin and/or kallikrein, as well as pharmaceutical compositions containing these compounds which are useful for inhibiting serine proteases and for treating disorders mediated thereby.
Normal haemeostasis is the result of a complex balance between the processes of clot initiation, formation and dissolution. The complex interactions between blood cells, specific plasma proteins and the vascular surface, maintain the fluidity of blood, however in the case of injury, blood coagulation is vital for the containment of bodily fluids and is an important component of host defense mechanisms. Many significant disease states are related to abnormal clot formation (thrombosis) in blood vessels. For example, in arterial vasculature abnormal thrombus formation due to deterioration of an established atherosclerotic plaque is a major cause of acute myocardial infarction and unstable angina. In venous vasculature, many patients undergoing surgery, particularly in the abdominal and lower body regions, experience thrombus formation which reduces blood flow and can lead to a pulmonary embolism. Disseminated intravascular coagulopathy in both the venous and arterial systems occurs commonly during septic shock, some viral infections and cancer which often leads to rapid and widespread thrombus formation and organ failure.
Coagulation and clotting (thrombus formation) involves the sequential activation of multiple zymogens in a process leading to thrombin generation which in turn is responsible for the conversion of fibrinogen to an impermeable cross-linked fibrin clot. Thrombin production is the result of a blood coagulation cascade which has been intensively studied and increasingly characterized. See for example, Lawson, J. H., et al. (1994) J. Biol. Chem. 269:23357. The coagulation reactions of this cascade involve initiation, amplification and propagation phases. Additionally, the cascade has been divided into extrinsic and intrinsic pathways. The intrinsic pathway involves factors XII, XI, and IX and leads to the formation of a complex of factor IXa with its cofactor, factor VIIIa. This complex converts factor X to Xa. Factor Xa is an enzyme which forms a complex with its cofactor, factor Va, and rapidly converts prothrombin to thrombin. Thrombin in turn converts fibrinogen to fibrin monomers which polymerize to form a clot. The extrinsic pathway involves factor VIIa and tissue factor, which form a complex (TF/factor VIIa), and convert factor X to Xa. As in the intrinsic pathway, factor Xa converts prothrombin to thrombin.
Thrombin (factor IIa), as noted above, occupies a central position in the coagulation cascade by converting fibrinogen to fibrin. Consequently, substantial synthetic efforts have been directed to the development of compounds that bind to thrombin in order to inhibit its activity such as N-arylsulfinated phenylalanine amides. Additional compounds which have been prepared as synthetic thrombin inhibitors are disclosed in U.S. Pat. No. 5,656,600; U.S. Pat. No. 5,656,645; U.S. Pat. No. 5,670,479; U.S. Pat. No. 5,646,165; U.S. Pat. No. 5,658,939; U.S. Pat. No. 5,658,930 and WO 97/30073. Many thrombin inhibitors have been designed to mimic the structure of hirudin, a protein produced by medicinal leeches (Hirudo medicinalis), which binds to thrombin thereby inhibiting coagulation. Stubbs and Bode, Current Opinion in Structural Biology 1994, 4:823-832. Further synthetic thrombin inhibitors are reported in Annual Reports in Medicinal Chemistry, 1995-1997, Academic Press, San Diego, Calif.
TF/factor VIIa is a serine protease complex that participates in blood coagulation by activating factor X and/or factor IX. Factor VIIa is produced from its precursor, factor VII, which is synthesized in the liver and secreted into the blood where it circulates as a single chain glycopeptide. The cDNA sequence for factor VII has been characterized (Hagen et al., 1986, Proc. Natl. Acad. Sci. U.S.A., 83:2412-2416). A variety of natural and synthetic inhibitors of TF/factor VIIa are known and have varying potency and selectivity such as those disclosed in U.S. Pat. No. 5,589,173 used to treat myocardial infarction. Tissue factor pathway inhibitor (TFPI; Broze, 1995, Thromb. Haemostas., 74:90) and nematode anticoagulant peptide c2 (NAPc2; Stanssens et al., 1996, Proc. Natl. Acad. Sci. U.S.A., 93:2149) bind factor Xa prior to the formation of a quaternary inhibitory complex with the TF/factor VIIa complex. Small protein direct inhibitors (Dennis et al, 1994, J. Biol. Chem., 35:22137) and inactive forms of TF/factor VIIa are also known (Kirchhofer et al, 1995, Arteriosclerosis, Thrombosis and Vascular Biol., 15:1098; Jang et al, 1995, Circulation, 92:3041). Additionally, synthetic peptides and soluble forms of mutant TF which retain binding affinity but have reduced cofactor activity have been prepared (Roenning et al, 1996, Thromb. Res., 82:73; Kelley et al, 1997, Blood, 89:3219). U.S. Pat. No. 5,679,639 describes polypeptides and antibodies which inhibit serine protease activity. U.S. Pat. No. 5,580,560 describes a mutant factor VIIa which has an improved half-life. U.S. Pat. No. 5,504,067 and U.S. Pat. No. 5,504,064 describe a truncated TF for the treatment of bleeding. Kunitz domain-tissue factor fusion proteins have also been shown to be bifunctional anticoagulants (Lee et al, 1997, Biochemistry, 36:5607-5611). The TF/factor VIIa complex has been indicated as an attractive target for the development of inhibitors based on a dissociation between surgical bleeding and prevention of intravascular thrombosis (Harker et al, 1995, Thromb. Haemostas., 74:464).
Factor Xa is also central to thrombosis since it is a product of both the intrinsic and extrinsic coagulation pathways. Inhibitors of factor Xa have been synthesized such as bisamidine compounds (Katakura, S. (1993) Biochem. Biophys. Res. Commun., 197:965), compounds based on the structure of arginine (WO 93/15756; WO 94/13693) and phenyl and naphthylsulfonamides (WO 96/10022; WO 96/16940; WO 96/40679).
Percutaneous transluminal coronary angioplasty (PTCA) and recanalization are favored procedures for treating occluded vessels. However, arterial thrombosis following these procedures remains a leading cause of failure. Anticoagulants including heparin, the most widely used anticoagulant, have not been shown to be entirely effective or safe in the treatment and prevention of acute arterial thrombosis or rethrombosis. Accordingly, there remains a need for compounds which are effective inhibitors of enzymes in the coagulation cascade and which exhibit improved inhibitory activity and/or selectivity towards selected enzymes in the cascade.
In an aspect of the present invention, there is provided novel compounds of formula (I) A compound of formula (I) 
wherein
X is O, CR6R6xe2x80x2, NR6, S, wherein R6 and R6xe2x80x2 are independently H or alkyl;
R1 is H, xe2x80x94OR7, an amino acid or xe2x80x94NR7R7xe2x80x2 wherein R7 and R7xe2x80x2 are independently H or a hydrocarbon chain, a carbocycle, a heterocycle, a carbocycle-substituted hydrocarbon chain or a heterocycle-substituted hydrocarbon chain optionally substituted with hydroxyl, halogen, cyano, amino, nitro, amidine, guanidine alkyl, halo-substituted alkyl, alkoxy, aryl or carboxyl; or R7 and R7xe2x80x2 together form a heterocycle optionally fused to another heterocycle or carbocycle wherein said heterocycle and carbocycle are optionally substituted with hydroxyl, halogen, amino, nitro, amidine, guanidine, alkyl, halo-substituted alkyl, alkoxy or carboxyl;
R2 is H or a hydrocarbon chain, a carbocycle or a carbocycle-substituted hydrocarbon chain optionally substituted with hydroxyl, oxo, halogen, cyano, amino, nitro, amidine, guanidine, alkyl, halo-substituted alkyl, alkoxy or carboxyl; and wherein said hydrocarbon chain is optionally interrupted with N, O, S, SO or SO2;
R3 is H or a protecting group;
R4 is selected from the group consisting of H, hydroxyl, halogen, amino, nitro, amidine, guanidine and acylamino;
R5 is H or R4 and R5 together form a 5 or 6 member carbocycle or heterocycle ring optionally substituted with hydroxyl, halogen, amino, nitro, amidine, guanidine or acylamino;
n is 0 or 1; and
salts, solvates and hydrates thereof.
In another aspect of the invention, there is provided pharmaceutical compositions comprising a compound of the invention and a pharmaceutically acceptable carrier.
In another aspect of the invention, there is provided a method of treating a disease or condition mediated by a serine protease in a mammal comprising administering to said mammal an effective amount of a compound of the invention.
The invention provides novel compounds of formula (I) 
wherein X, R1, R2, R3, R4 and R5 are as defined herein.
The term xe2x80x9camino acidxe2x80x9d refers to naturally and non-naturally occurring xcex1-(alpha), xcex2-(beta), D- and L-amino acid residues. Preferred amino acid residues are hydrophobic such as alanine, xcex2-alanine, phenylalanine, valine, leucine and isoleucine.
The term xe2x80x9chydrocarbon chainxe2x80x9d refers to saturated, unsaturated, linear or branched carbon chains i.e. alkyl, alkenyl and alkynyl. Preferred hydrocarbon chains incorporate 1-12 carbon atoms, more preferably 1-6 and most preferably 1-4 carbon atoms i.e. methyl, ethyl, propyl, butyl and allyl.
The term xe2x80x9ccarbocyclexe2x80x9d refers to a mono-, bi- or tri-cyclic carbon ring or ring system having 4-16 members which is saturated, unsaturated or partially unsaturated including aromatic ring systems. Preferred carbocyclic rings include cyclopentyl, cyclohexyl, phenyl and naphthyl.
The term xe2x80x9cheterocyclexe2x80x9d refers to a mono-, bi- or tri-cyclic ring system having 5-16 members wherein at least one ring atom is a heteroatom (i.e. N, O and S as well as SO, or SO2). The ring system is saturated, unsaturated or partially unsaturated and may be aromatic. Preferred heterocycles include piperidine, piperazine, pyridine, pyrazine, pyrimidine, pyridazine, morpholine, pyran, pyrole, furan, thiophene (thienyl), imidazole, pyrazole, thiazole, isothiazole, dithiazole, oxazole, isoxazole, dioxazole, thiadiazole, oxadiazole, tetrazole, triazole, thiatriazole, oxatriazole, thiadiazole, oxadiazole, purine, and benzofused derivatives thereof.
X is O, CR6R6xe2x80x2, NR6 or S, wherein R6 and R6xe2x80x2 are independently H or alkyl. In a particular embodiment X is O. In another particular embodiment, X is CR6R6xe2x80x2 wherein R6 and R6xe2x80x2 are both H.
R1 is H, xe2x80x94OR7, an amino acid or xe2x80x94NR7R7xe2x80x2 wherein R7 and R7xe2x80x2 are independently H or a hydrocarbon chain, a carbocycle, a heterocycle, a carbocycle-substituted hydrocarbon chain or a heterocycle-substituted hydrocarbon chain optionally substituted with one or more hydroxyl, halogen (i.e. F, Cl, Br, I), cyano, amino (i.e. NH2 or a secondary or tertiary amine), nitro, amidine (xe2x80x94C(NH)xe2x80x94NH2), guanidine (xe2x80x94NHxe2x80x94C(NH)xe2x80x94NH2), alkyl, halo-substituted alkyl, alkoxy, aryl or carboxyl. By xe2x80x9ccarboxylxe2x80x9d is meant herein as the free acid xe2x80x94COOH as well as esters thereof such as alkyl esters. By xe2x80x9calkoxyxe2x80x9d is meant herein to include saturated, i.e. O-alkyl, and unsaturated, i.e. O-alkenyl and O-alkynyl, group. By xe2x80x9carylxe2x80x9d in meant herein to be an aromatic carbon ring or ring system such as benzene/phenyl, naphthyl, phenanthrenyl etc. as well as biphenyl. In a particular embodiment, R1 is xe2x80x94OR7 wherein R7 is a hydrocarbon chain such as alkenyl i.e. allyl. In another embodiment R1 is xe2x80x94NR7R7xe2x80x2 wherein R7 is aryl or aralkyl optionally substituted with one or more hydroxyl, halogen, amino, amidine, guanidine, cyano, alkyl, alkoxy, halo-substituted alkyl; and R7xe2x80x2 is H or alkyl. In a preferred embodiment, R1 is xe2x80x94NR7R7xe2x80x2 wherein R7 is phenyl or benzyl substitute with amidine or alkoxy and R7xe2x80x2 is H or methyl. In a particularly preferred embodiment R7 is benzyl, p-amidinylphenyl, p-methoxybenzyl or p-methylbenzyl and R7xe2x80x2 is H.
In another embodiment, R1 is xe2x80x94NR7R7xe2x80x2 wherein R7 and R7xe2x80x2 together form a heterocyle optionally fused to another heterocycle or carbocycle wherein said heterocycle and carbocycle are optionally substituted with one or more hydroxyl, halogen, amino, nitro, amidine, guanidine, alkyl, halo-substituted alkyl, alkoxy or carboxyl. In a particular embodiment, R7 and R7xe2x80x2 together form a piperidine ring fused to a benzene ring wherein said fused benzene ring is optionally substituted with one or more alkoxy. Preferably, the fused benzene ring is substituted at both beta carbon positions with methoxy.
R2 is H or a hydrocarbon chain, a carbocycle or a carbocycle-substituted hydrocarbon chain optionally substituted with one or more hydroxyl, oxo (xe2x95x90O), halogen (preferably F or Cl), cyano, amino, nitro, amidine, guanidine, alkyl, halo-substituted alkyl, alkoxy (preferably methoxy) or carboxyl; and wherein said hydrocarbon chain is optionally interrupted with N, O, S, SO or SO2. By xe2x80x9cinterruptedxe2x80x9d is meant herein that one or more carbon atoms within a hydrocarbon chain is replaced with said heteroatom. When a hydrocarbon chain is interrupted with two or more heteroatoms, preferably the heteroatoms are non-adjacent. In the context of R2, the heteroatom is adjacent to the ring nitrogen atom from which the hydrocarbon chain depends. In a preferred embodiment, R2 is H, alkyl, cycloalkyl, aryl, cycloalkylalkyl or aralkyl optionally substituted with one or more alkyl, amino, amidine, guanidine or nitro. In a more preferred embodiment R2 is H, alkyl, aryl, aralkyl or cycloalkyl and most preferably propyl, phenylethyl, cyclohexyl, o-nitrobenzyl or m-methylbenzyl.
R3 is H or a protecting group. Preferably R3 is H.
When xe2x80x98nxe2x80x99 is zero (0), R4 is not present and X is attached to the benzamidine ring at that position. When n is the integer 1, R4 is present and is selected from the group consisting of H, hydroxyl, halogen, amino, nitro, amidine, guanidine and acylamino. By xe2x80x9cacylaminoxe2x80x9d is meant herein to be a carboxamide group xe2x80x94NHC(O)xe2x80x94hydrocarbon wherein the hydrocarbon is as previously defined and is preferably alkyl. Preferably, R4 is H or amino and most preferably H.
R5 is H or R4 and R5 together form a 5 or 6 member carbocycle or heterocycle ring optionally substituted with one or more hydroxyl, halogen, amino, nitro, amidine, guanidine or acylamino. In a particular embodiment, R5 is H. In another particular embodiment, R4 and R5 form a benzene ring fused to the benzamidine ring from which R4 and R5 depend.
Preferred compounds of the invention include: 
salts, solvates and hydrates thereof.
It will be appreciated that compounds of the invention may incorporate chiral centers and therefore exist as geometric and stereoisomers. All such isomers are contemplated and are within the scope of the invention whether in pure isomeric form or in mixtures of such isomers as well as racemates. Stereoisomeric compounds may be separated by established techniques in the art such as chromatography, i.e. chiral HPLC, or crystallization methods.
xe2x80x9cPharmaceutically acceptablexe2x80x9d salts include both acid and base addition salts. Pharmaceutically acceptable acid addition salt refers to those salts which retain the biological effectiveness and properties of the free bases and which are not biologically or otherwise undesirable, formed with inorganic acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, carbonic acid, phosphoric acid and the like, and organic acids may be selected from aliphatic, cycloaliphatic, aromatic, arylaliphatic, heterocyclic, carboxylic, and sulfonic classes of organic acids such as formic acid, acetic acid, propionic acid, glycolic acid, gluconic acid, lactic acid, pyruvic acid, oxalic acid, malic acid, maleic acid, malonic acid, succinic acid, fumaric acid, tartaric acid, citric acid, aspartic acid, ascorbic acid, glutamic acid, anthranilic acid, benzoic acid, cinnamic acid, mandelic acid, embonic acid, phenylacetic acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid and the like.
Pharmaceutically acceptable base addition salts include those derived from inorganic bases such as sodium, potassium, lithium, ammonium, calcium, magnesium, iron, zinc, copper, manganese, aluminum salts and the like. Particularly preferred are the ammonium, potassium, sodium, calcium and magnesium salts. Salts derived from pharmaceutically acceptable organic nontoxic bases includes salts of primary, secondary, and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines and basic ion exchange resins, such as isopropylamine, trimethylamine, diethylamine, triethylamine, tripropylamine, ethanolamine, 2-diethylaminoethanol, trimethamine, dicyclohexylamine, lysine, arginine, histidine, caffeine, procaine, hydrabamine, choline, betaine, ethylenediamine, glucosamine, methylglucamine, theobromine, purines, piperazine, piperidine, N-ethylpiperidine, polyamine resins and the like. Particularly preferred organic non-toxic bases are isopropylamine, diethylamine, ethanolamine, trimethamine, dicyclohexylamine, choline, and caffeine.
Compounds of the invention may be prepared according to established organic synthesis techniques from starting materials and reagents that are commercially available or from starting materials that may be prepared from commercially available starting materials. Many standard chemical techniques and procedures are described in March, J., xe2x80x9cAdvanced Organic Chemistryxe2x80x9d McGraw-Hill, New York, 1977; and Collman, J., xe2x80x9cPrinciples and Applications of Organotransition Metal Chemistryxe2x80x9d University Science, Mill Valley, 1987; and Larock, R., xe2x80x9cComprehensive Organic Transformationsxe2x80x9d Verlag, New York, 1989. It will be appreciated that depending on the particular substituents present on the compounds, suitable protection and deprotection procedures will be required in addition to those steps described herein. Numerous protecting groups are described in Greene and Wuts, Protective Groups in Organic Chemistry, 2d edition, John Wiley and Sons, 1991, as well as detailed protection and deprotection procedures. For example, suitable amino protecting groups include t-butyloxycarbonyl (Boc), fluorenyl-methyloxycarbonyl (Fmoc), 2-trimethylsilyl-ethyoxycarbonyl (Teoc), 1-methyl-1-(4-biphenylyl)ethoxycarbonyl (Bpoc), allyloxycarbonyl (Alloc), and benzyloxycarbonyl (Cbz). Carboxyl groups can be protected as fluorenylmethyl groups, or alkyl esters i.e. methyl or ethyl, or alkenyl esters such as allyl. Hydroxyl groups may be protected with trityl, monomethoxytrityl, dimethoxytrityl, and trimethoxytrityl groups.
In a particular embodiment wherein X is O, compounds of the invention may be prepared according to scheme 1. 
Referring to scheme 1, commercially available N-protected hydroxyproline (i.e. Boc or Teoc-protected) (i) is converted to allyl ester (iii) by reacting with triphenyl phosphine (PPh3) and DEAD and then with allyl alcohol in the presence of Ti(IV)isopropoxide. The allyl ester (iii) is then coupled in a Mitsunobu reaction with N-protected meta- or para-hydroxybenzamidine (i.e. Boc-protected) in the presence of PPh3 and DEAD to give intermediate (v). The allyl group is removed with Pd tetrakis (PPh3) in an n-methyl morpholine (i.e. 5%), acetic acid (i.e. 2/5%) solution of chloroform to give free carboxylic acid (vi) which is reacted with amine HNR7R7xe2x80x2, an amino acid or alcohol HOxe2x80x94R7 to give (vii). For amine HNR7R7xe2x80x2 and amino acid coupling, the carboxyl acid (vi) is first activated for example with HBTU and HOBt according to standard amide formation procedures. In a particular embodiment wherein R1 of compounds of the invention is xe2x80x94NR6-phenyl (optionally substituted), the carboxylic acid is activated with NCS and triphenyl phosphine followed by addition of anilines. The N-protecting group on the proline moiety is then removed from (vii) and the resulting compound (viii) is optionally alkylated acylated or sulfonylated to give compound (ix). When the protecting group is Teoc (trimethylsilylethoxycarbonyl), deprotection is achieved by treatment with tbaf (i.e. about 0.24M) in tetrahydrofuran (thf). Alkylation of intermediate (viii) is achieved via standard reductive amination using various aldehydes, a catalyst and an appropriate reducing agent, or can be achieved by SN2 type displacements by treating with an alkyl halide and standard non-nucleophilic base. Acylation of intermediate (viii) is achieved by standard amide bond formation chemistry by activating the desired R2 carboxylic acid and reacting with the free amine of (viii). Alternatively the amine of (viii) may be acylated by treating with various acid chlorides of R2 and standard non-nucleophilic base such as Hunig""s base. Sulfonylation of is achieved by reacting the free amine of intermediate (viii) with various sulfonyl chlorides of R2 with a non-nucleophilic base such as a Hunig""s base.
The amidine protecting group of (ix) is subsequently removed to give final compound of formula (I) of the invention wherein X is O.
In another particular embodiment wherein X is NH, compounds of the invention may be prepared according to scheme 2. 
Referring to scheme 2, starting reagent cyanoaniline (i) is reacted with trifluoroacetic acid (TFA) activated with HBTU and HOBt to give intermediate (ii) which is coupled with allyl ester of N-protected hydroxyproline (iii) to give intermediate (iv). The allyl group is converted to the free carboxylic acid and then reacted with amine HNR7R7xe2x80x2, amino acid, or alcohol HOxe2x80x94R7 and the N-protecting group on the proline is removed and optionally alkylated, acylated or sulfonylated as described with respect to scheme 1. The trifluoroacetyl group is removed by reacting (viii) with lithiumhydroxide in thf/H2O to give (ix). Nitrile intermediate (ix) is converted to a hydroxyamidine (x) by reacting with hydroxylamine hydrochloride and TEA and is subsequently reduced to amidine (xi) by treating with hydrogen and a metal hydrogenation catalysts such as Raney nickel or palladium.
In another particular embodiment wherein X is CH2, compounds of the invention may be prepared according to scheme 3. 
Referring to scheme 3, starting cyanobenzylbromide compound (i) is converted to a phosphonium salt (ii) by reacting with PPh3 in pyridine which then undergoes a Wittig olefin forming reaction with keto-proline intermediate (iii) to give intermediate (iv). Intermediate (iii) is prepared from an N-protected proline ester for example N-Teoc protected proline methyl ester which undergoes a Swern oxidation in the presence of oxalochloride and triethylamine (TEA). Olefin intermediate (iv) is reduced with Pd catalyst and H2 to give (v). The ester group is converted to the free carboxylic acid and then reacted with amine HNR7R7xe2x80x2, amino acid, or alcohol HO-R7 and the N-protecting group on the proline is removed and optionally alkylated, acylated or sulfonylated as described with respect to scheme 1. Nitrile intermediate (ix) is converted to a hydroxyamidine (x) by reacting with hydroxylamine hydrochloride and TEA and is subsequently reduced to amidine (xi) by treating with hydrogen and a metal hydrogenation catalysts such as Raney nickel or palladium.
In an aspect of the invention, there is provided a method of inhibiting the binding of a serine protease (such as factor VIIa, TF/factor Xa complex, thrombin, trypsin, plasmin and kallikrein) to a protein ligand, the method comprising contacting said serine protease with a compound of formula (I). The method may be carried out in vivo or ex vivo as a solution based or cell based assay wherein the compound of the invention is introduced to the serine protease in the presence of a putative or known ligand of the protease. The compound of the invention may be labeled, for example isotopically radiolabeled, or labeled with a fluorophore such as FITC, to facilitate detection of ligand binding or reduction thereof to the protease. Thus compounds of the invention are useful for diagnostic and screening assays.
Compounds of the invention are therapeutically and/or prophylactically useful for treating diseases or conditions mediated by serine protease activity. Accordingly in an aspect of the invention, there is provided a method of treating a disease or condition mediated by serine proteases in a mammal, i.e. a human, comprising administering to said mammal an effective amount of a compound of the invention. By xe2x80x9ceffective amountxe2x80x9d is meant an amount of compound which upon administration is capable of reducing the activity of the serine protease; or the amount of compound required to prevent, inhibit or reduce blood coagulation or thrombus formation upon administration; or is capable of alleviating or reducing the severity of symptoms associated with the disease or condition mediated by serine proteases. Compounds of the invention may also be used as an additive to blood samples or reserves in order to prevent coagulation. Accordingly there is also provided a method of inhibiting coagulation of mammalian blood (i.e. human blood), comprising introducing a compound of the invention to said blood.
The actual amount of compound administered and the route of administration will depend upon the particular disease or condition as well as other factors such as the size, age, sex and ethnic origin of the individual being treated and is determined by routine analysis. In general, intravenous doses will be in the range from about 0.01-1000 mg/kg of patient body weight per day, preferably 0.1 to 20 mg/kg and 0.3 to 15 mg/kg. Administration may be once or multiple times per day for several days, weeks or years or may be a few times per week for several weeks or years. The amount of compound administer by other routes will be that which provides a similar amount of compound in plasma compared to the intravenous amounts described which will take into consideration the plasma bioavailability of the particular compound administered.
In methods of the invention, the compound may be administered orally (including buccal, sublingual, inhalation), nasally, rectally, vaginally, intravenously (including intrarterially), intradermally, subcutaneously, intramuscularly and topically. Compounds will be formulated into compositions suitable for administration for example with suitable carriers, diluents, thickeners, adjuvants etc. as are routine in the formulation art. Accordingly, another aspect of the invention provides pharmaceutical compositions comprising a compound of formula (I) and a pharmaceutically acceptable carrier, excipient or adjuvant.
Compositions of the invention may also include additional active ingredients in particular additional anticoagulants (eg. aspirin, warfarin, heparin) and/or thrombolytic agents (eg. streptokinase, tPA, TNKase(trademark)). Dosage forms include solutions, powders, tablets, capsules, gel capsules, suppositories, topical ointments and creams and aerosols for inhalation. Formulations for non-parenteral administration may include sterile aqueous solutions which may also contain buffers, diluents and other suitable additives. Pharmaceutically acceptable organic or inorganic carrier substances suitable for non-parenteral administration which do not deleteriously react with compounds of the invention can be used. Suitable pharmaceutically acceptable carriers include, but are not limited to, water, salt solutions, alcohol, polyethylene glycols, gelatin, lactose, amylose, magnesium stearate, talc, silicic acid, viscous paraffin, hydroxymethylcellulose, polyvinylpyrrolidone and the like. The formulations can be sterilized and, if desired, mixed with auxiliary agents, e.g., lubricants, preservatives, stabilizers, wetting agents, emulsifiers, salts for influencing osmotic pressure, buffers, colorings flavorings and/or aromatic substances and the like which do not deleteriously react with compounds of the invention. Aqueous suspensions may contain substances which increase the viscosity of the suspension including, for example, sodium carboxymethylcellulose, sorbitol and/or dextran. Optionally, the suspension may also contain stabilizers.
In a preferred embodiment, compounds of the invention are administered via oral delivery. Compositions for oral administration include powders or granules, suspensions or solutions in water or non-aqueous media, capsules, sachets, troches, tablets or SECs (soft elastic capsules or caplets). Thickeners, flavoring agents, diluents, emulsifiers, dispersing aids, carrier substances or binders may be desirably added to such formulations. Such formulations may be used to effect delivering the compounds to the alimentary canal for exposure to the mucosa thereof. Accordingly, the formulation can consist of material effective in protecting the compound from pH extremes of the stomach, or in releasing the compound over time, to optimize the delivery thereof to a particular mucosal site. Enteric coatings for acid-resistant tablets, capsules and caplets are known in the art and typically include acetate phthalate, propylene glycol and sorbitan monoleate.
Various methods for producing formulations for alimentary delivery are well known in the art. See, generally Remington""s Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990. The formulations of the invention can be converted in a known manner into the customary formulations, such as tablets, coated tablets, pills, granules, aerosols, syrups, emulsions, suspensions and solutions, using inert, non-toxic, pharmaceutically suitable excipients or solvents. The therapeutically active compound should in each case be present in a concentration of about 0.5% to about 99% by weight of the total mixture, that is to say in amounts which are sufficient to achieve the desired dosage range. The formulations are prepared, for example, by extending the active compounds with solvents and/or excipients, if appropriate using emulsifying agents and/or dispersing agents, and, for example, in the case where water is used as the diluent, organic solvents can be used as auxiliary solvents if appropriate.
Compositions may also be formulated with binding agents (e.g., pregelatinized maize starch, polyvinylpyrrolidone or hydroxypropyl methylcellulose); fillers (e.g., lactose, microcrystalline cellulose or calcium hydrogen phosphate); lubricants (e.g., magnesium stearate, talc or silica); disintegrates (e.g., starch or sodium starch glycolate); or wetting agents (e.g., sodium lauryl sulfate). Tablets may be coated by methods well known in the art. The preparations may also contain flavoring, coloring and/or sweetening agents as appropriate.
Formulations of the present invention suitable for oral administration may be presented as discrete units such as capsules, cachets or tablets each containing predetermined amounts of the active ingredients; as powders or granules; as solutions or suspensions in an aqueous liquid or a non-aqueous liquid; or as oil-in-water emulsions or water-in-oil liquid emulsions. A tablet may be made by compression or molding, optionally with one or more accessory ingredients. Compressed tablets may be prepared by compressing in a suitable machine, the active ingredients in a free-flowing form such as a powder or granules, optionally mixed with a binder, lubricant, inert diluent, preservative, surface active or dispersing agent. Molded tablets may be made by molding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent. The tablets may optionally be coated or scored and may be formulated so as to provide slow or controlled release of the active ingredients therein.